The cauda equina (from Latin tail of horse) is a bundle of spinal nerves and spinal nerve rootlets, consisting of the second through fifth lumbar nerve pairs, the first through fifth sacral nerve pairs, and the coccygeal nerve, all of which arise from the lumbar enlargement and the conus medullaris of the spinal cord. The cauda equina occupies the lumbar cistern, a subarachnoid space inferior to the conus medullaris. The nerves that compose the cauda equina innervate the pelvic organs and lower limbs to include motor innervation of the hips, knees, ankles, feet, internal anal sphincter and external anal sphincter. In addition, the cauda equina extends to sensory innervation of the perineum and, partially, parasympathetic innervation of the bladder.
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👉 Cauda equina in the context of Cauda equina syndrome
Cauda equina syndrome (CES) is a condition that occurs when the bundle of nerves below the end of the spinal cord known as the cauda equina is damaged. Signs and symptoms include low back pain, pain that radiates down the leg, numbness around the anus, and loss of bowel or bladder control. Onset may be rapid or gradual.
The cause is usually a disc herniation in the lower region of the back. Other causes include spinal stenosis, cancer, trauma, epidural abscess, and epidural hematoma. The diagnosis is suspected based on symptoms and confirmed by medical imaging such as MRI or CT scan.
Cauda equina in the context of Spinal cord
The spinal cord is a long, thin, tubular structure made up of nervous tissue that extends from the medulla oblongata in the lower brainstem to the lumbar region of the vertebral column (backbone) of vertebrate animals. The center of the spinal cord is hollow and contains a structure called the central canal, which contains cerebrospinal fluid. The spinal cord is also covered by the meninges and enclosed by the neural arches. Together, the brain and spinal cord make up the central nervous system.
In humans, the spinal cord is a continuation of the brainstem and anatomically begins at the occipital bone, passing out of the foramen magnum and then enters the spinal canal at the beginning of the cervical vertebrae. The spinal cord extends down to between the first and second lumbar vertebrae, where it tapers to become the cauda equina. The enclosing bony vertebral column protects the relatively shorter spinal cord. It is around 45 cm (18 in) long in adult men and around 43 cm (17 in) long in adult women. The diameter of the spinal cord ranges from 13 mm (1⁄2 in) in the cervical and lumbar regions to 6.4 mm (1⁄4 in) in the thoracic area.
Cauda equina in the context of Hard flaccid syndrome
Hard flaccid syndrome (HFS), also known as hard flaccid (HF), is a rare acquired dysautonomic condition characterized by a flaccid penis that remains in a firm, semi-rigid state in the absence of sexual arousal. Patients often describe their flaccid penis as firm to the touch, rubbery, shrunken, and retracted, frequently accompanied by pain, discomfort, and various other symptoms. While the condition is not fully understood, current research indicates that HFS results from excessive sympathetic nervous system activity in the smooth muscle tissue of the penis, triggered by a pathological activation of a proposed pelvic/pudendal-hypogastric reflex. Among other causes, injuries to the erect penis, blunt trauma to the pelvis or perineum, and damage to the cauda equina are thought to induce this reflex. Although unproven, axon sprouting in sympathetic ganglia following a peripheral nerve injury is a possible explanation for HFS. The majority of patients are in their 20s and 30s, with symptoms severely affecting their quality of life. Treatment typically involves a combination of alpha blockers and PDE5 inhibitors, although there is limited evidence supporting their efficacy. Due to the lack of comprehensive understanding and awareness within the scientific and medical communities, there is currently no definitive treatment for HFS.
Cauda equina in the context of Spinal canal
In human anatomy, the spinal canal, vertebral canal or spinal cavity is an elongated body cavity enclosed within the dorsal bony arches of the vertebral column, which contains the spinal cord, spinal roots and dorsal root ganglia. It is a process of the dorsal body cavity formed by alignment of the vertebral foramina. Under the vertebral arches, the spinal canal is also covered anteriorly by the posterior longitudinal ligament and posteriorly by the ligamentum flavum. The potential space between these ligaments and the dura mater covering the spinal cord is known as the epidural space. Spinal nerves exit the spinal canal via the intervertebral foramina under the corresponding vertebral pedicles.
In humans, the spinal cord gets outgrown by the vertebral column during development into adulthood, and the lower section of the spinal canal is occupied by the filum terminale and a bundle of spinal nerves known as the cauda equina instead of the actual spinal cord, which finishes at the L1/L2 level.
Cauda equina in the context of Conus medullaris
The conus medullaris (Latin for "medullary cone") or conus terminalis is the tapered, lower end of the spinal cord. It occurs near lumbar vertebral levels 1 (L1) and 2 (L2), occasionally lower. The upper end of the conus medullaris is usually not well defined, however, its corresponding spinal cord segments are usually S1–S5.
After the spinal cord tapers out, the spinal nerves continue to branch out diagonally, forming the cauda equina.